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多发性硬化症患者视神经炎发作对脉络膜血流指数的影响。

The effect of optic neuritis attacks on choroidal vascularity index in patients with multiple sclerosis.

机构信息

Department of Ophthalmology, University of Health Sciences, Haydarpasa Numune Training and Research Hospital, Tibbiye St No: 23, 34668, Uskudar, Istanbul, Turkey.

出版信息

Graefes Arch Clin Exp Ophthalmol. 2021 Aug;259(8):2413-2424. doi: 10.1007/s00417-021-05143-x. Epub 2021 Mar 25.

Abstract

PURPOSE

To investigate the changes in the choroidal vascularity index (CVI) of patients with multiple sclerosis (MS) using binarization on enhanced depth imaging optical coherence tomography (EDI-OCT) images and to evaluate the effect of optic neuritis (ON) attacks on these measurements.

METHOD

Three groups were created by including forty eyes of 20 patients diagnosed with relapsing-remitting MS and had a unilateral history of ON attack and the randomly selected eyes of 30 healthy age- and sex-matched control subjects. Group 1 (n = 20) consisted of the ON-affected eyes of the MS patients (MSON); group 2 (n = 20) included their fellow healthy eyes (MSNON); group 3 (n = 30) included the eyes of healthy controls.

RESULTS

The mean age was 33.3 ± 9.4 years in the MS group and 33.4 ± 11.1 years in the healthy control group. Mean choroidal vascularity index (CVI) was significantly lower in the MSON group than the MSNON group (59.6 ± 3.72 % vs 61.7 ± 3.16 %, p = 0.007). The CVI values of both the MSON and MSNON groups were significantly lower when compared to the controls (63.9 ± 2.76) (p < 0.001, p = 0.030). Compared to controls, the subfoveal total choroidal area and luminal area values were significantly greater in the MSON (p = 0.009, p = 0.009, respectively) and MSNON groups (p = 0.031, p = 0.013, respectively).

CONCLUSION

The presented study demonstrates that, compared to healthy subjects, CVI values are lower in the affected and unaffected eyes of patients who had a history of ON in relation with their MS diagnosis. The presence of significant anatomical changes, especially in the luminal area, may suggest that ON causes vascular disorganization which contributes to MS pathophysiology.

摘要

目的

通过对增强深度成像光学相干断层扫描(EDI-OCT)图像进行二值化处理,研究多发性硬化症(MS)患者脉络膜血管指数(CVI)的变化,并评估视神经炎(ON)发作对这些测量的影响。

方法

纳入 20 例单侧 ON 发作史的复发性缓解型 MS 患者的 40 只眼,以及 30 名年龄和性别匹配的健康对照者的随机选择的 40 只眼,创建了 3 组。第 1 组(n = 20)由 MS 患者的患眼(MSON)组成;第 2 组(n = 20)包括他们的对侧健康眼(MSNON);第 3 组(n = 30)包括健康对照组的眼。

结果

MS 组的平均年龄为 33.3 ± 9.4 岁,健康对照组的平均年龄为 33.4 ± 11.1 岁。MSON 组的平均脉络膜血管指数(CVI)明显低于 MSNON 组(59.6 ± 3.72%比 61.7 ± 3.16%,p = 0.007)。与对照组相比,MSON 和 MSNON 两组的 CVI 值均显著降低(63.9 ± 2.76)(p < 0.001,p = 0.030)。与对照组相比,MSON 和 MSNON 组的中心凹下全脉络膜面积和管腔面积值均显著增大(p = 0.009,p = 0.009,分别)和(p = 0.031,p = 0.013,分别)。

结论

本研究表明,与健康受试者相比,ON 病史与 MS 诊断相关的患者的患眼和未患眼的 CVI 值较低。存在显著的解剖结构变化,特别是管腔面积,可能表明 ON 导致血管紊乱,这有助于 MS 发病机制。

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